الفهرس 
As a novel biomarker for acute rheumatic carditis and chronic rheumatic heart disease patients
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Abstract
Background: Rheumatic fever is a chronic inflammatory disease that can develop as a complication of inadequate treatment of group A beta-hemolytic streptococci bacteria. Rheumatic fever causes chronic progressive damage to the heart and its valves and is the most common cause of pediatric heart disease in the world (Parrilo and Klimke., 2014).Tenascin-C is a multifunctional hexameric glycoprotein and it is a major component of the ECM. It is synthesized by interstitial fibroblasts and increases in inflammatory diseases (Golledge et al., 2011). The aim of this study determine the role of serum Tenascin-C in the diagnosis of acute rheumatic carditis and chronic rheumatic heart disease. Patients and methods: This study is a case control one in which the patient group was represented by 60 Egyptian children,Twenty patients with acute rheumatic fever, the diagnosis was based on Jones criteria update 1992(Ferrieri, 2002). Furthermore the acute rheumatic fever group was split into two groups: patients with carditis and those with isolated arthritis, 20 patients with chronic rheumatic heart disease and 20 age and sex matched healthy children was served as a control group. Results: There was a statistical significant difference in the tenascin level between the three groups (p= 0.028) where the Tenascin C level was significantly increased in acute and chronic groups when compared with control group (p= 0.045; 0.011), respectively. On the other hand there was no statistical significant difference in the Tenascin C level between acute and chronic group (p= 0.607) Conclusion: Our results revealed that we cannot depend upon these results to relay upon the diagnosis of rheumatic fever using Tenascin C to evaluate the severity of the disease as our study was conducted on a small number of cases due to the dramatic decrease of rheumatic fever cases now days due to proper diagnosis and early prophylaxis and treatment